Despite the presence of the electronic medical record (EMR), the use of paper forms has persisted in many unpredictable and fast-paced medical settings because computer entry is often not immediately accessible or rapid enough using current digital interfaces. The use of paper to address limitations of the EMR in these settings is a barrier to implementing real-time information processing for improving patient care. Recent technological advances, such as the digital pen and paper technology, have begun to bridge the paper-digital gap. The digital pen is a tool that allows capturing the location and time of all written pen marks for real-time processing and display. The use of digital pens has been studied in several medical settings as a method of supporting data archiving but has not been evaluated as a tool to aid collaborative work in a setting requiring rapid acquisition, sharing and interpretation of information. The goal of this project is to support the collaborative work of teams in fast-paced, safety-criticl settings by capturing information from paper forms and presenting it in real-time on a dynamic peripheral display. We have developed a feasibility prototype system that uses a digital pen and a large wall display for real-time data capture and presentation in trauma resuscitation, the unpredictable and fast-paced initial management and treatment of injured patients. In this proposal, we will build on this prototype and evaluate its impact on team performance in simulated trauma resuscitations. Our overall hypothesis is that real-time information display will improve the performance of multidisciplinary teams in a dynamic medical setting. To test this hypothesis, we will pursue two aims: 1) design a digital capture and peripheral display system that supports the information needs and situation awareness of teams during trauma resuscitation; and 2) compare team performance during simulated trauma resuscitations with and without the digital data capture and peripheral display system. We will pursue Aim 1 using an iterative design approach that relies on participatory workshops, heuristic evaluation, simulation and rapid prototyping. We will pursue Aim 2 by measuring the time until initial management of life-threatening conditions during simulated trauma resuscitations. Our multidisciplinary team is well suited to conduct the proposed work and includes experts in resuscitation, computer science, systems engineering, cognitive science and human-centered design. Our long-term goal is to design and implement real-time decision support to aid dynamic and safety-critical medical teamwork. This high-risk, high yield proposal will bridge the paper-digital divide in dynamic medical domains by assessing the feasibility and impact of using digital pen and paper technology for real-time data capture and display.